Cigarette smoking and arteriographically demonstrable coronary artery disease

Patients undergoing selective coronary arteriography were studied to determine whether the extend of their coronary artery disease (CAD) was related to cigarette consumption. Those without demonstrable lesions averaged 29.0 pack years. Patients with single vessel disease, 38.3 pack years, those with double vessel disease 44.9 pack years and those with triple vessel disease 67.5 pack years. Nonsmokers with significant CAD were ten years older than their smoking counterparts (p less than 0.01). Forty-seven percent of patients with no demonstrable disease were nonsmokers whereas only 18 percnet of those with CAD were nonsmokers (p less than 0.001). Sixty-nine percent of nonsmoking normotensive patients had no CAD whereas only 23 percent of nonsmoking hypertensive patients fell in the no CAD category (p=0.01-0.005). This study demonstrates a correlation between the number of cigarettes consumed and the severity of CAD as well as the accelerating effect of cigarette consumption on the development of CAD. It also suggests that symptomatic CAD in a normotensive nonsmoker is unusual.